Disclaimer: This article provides general information on Nevada workers’ compensation. It does not offer legal advice. Consult an attorney or the Nevada Division of Industrial Relations for guidance tailored to your situation.
Detailed Answer
Under Nevada law, employers and their insurers must pay for all reasonable and necessary medical treatment related to a workplace injury without cost to you. To confirm whether those payments actually applied to your medical bills, follow these steps:
1. Review Your Medical Provider’s Billing Statement
Ask your doctor or hospital for an itemized statement of services rendered. This statement should list each procedure, date of service and the amount billed. Compare these charges against any payments recorded on the statement. If the insurer paid the provider, the statement will show a zero balance or note “Paid by Workers’ Compensation.”
2. Request an Explanation of Benefits (EOB) from the Insurer
Under NRS 616C.150, your employer’s workers’ compensation insurer must issue payments directly to medical providers. You can formally request an EOB or payment summary from the claims adjuster. The EOB will list the billed amount, the portion paid by workers’ compensation and any remaining balance you may owe, if applicable.
3. Contact Your Employer’s Claims Administrator
If you haven’t received clear documentation, call the claims administrator handling your case. Provide your claim number and dates of treatment. Ask for verification of payments made on your behalf and request written confirmation.
4. Access Records from Nevada Division of Industrial Relations
The Nevada Division of Industrial Relations (DIR) maintains records for all workers’ compensation claims. You can submit a public records request online or by mail to review payment logs and correspondence between your medical provider and the insurer. Use DIR’s website: dir.nv.gov/WCS/main/.
5. Review Applicable Statutes
Nevada Revised Statutes ensure transparency in workers’ compensation medical payments:
- NRS 616C.060 – Notice and proof of claim requirements
- NRS 616C.150 – Payment of compensation to medical providers
By following these steps and consulting the statutes, you can ensure workers’ compensation paid your medical bills correctly and you won’t face unexpected expenses.
Helpful Hints
- Keep copies of all medical bills and insurer correspondence in one folder.
- Note dates, names and reference numbers when you call your insurer or claims adjuster.
- Attend all scheduled medical appointments and follow provider instructions to avoid coverage disputes.
- Use certified mail or email receipts when requesting records to track delivery.
- If you find unpaid charges, file a complaint with the Nevada DIR’s Workers’ Compensation Section.